Long Sightedness And Laser Eye Surgery

What Is Hyperopia?

Long sightedness, or hyperopia as it's known amongst the medical profession, is one of the most common forms of visual impairment. In fact, so many people suffer with hyperopia to some degree that it's very difficult to determine exactly what percentage of the population have this condition. It's estimated to be around 13 percent of under 25's, rising to 66 percent in those aged over 80.

Hyperopia is a refractive error, which simply means that it causes visual impairment due to the fact that a part of the eye, usually the cornea, the lens, or the eyeball itself, is slightly misshapen, so the refraction of light is obscured or distorted, resulting in an unclear image.

With hyperopia the refraction of light is obscured or distorted, resulting in an unclear image.

In the case of long sightedness, this means that close up objects are often distorted, whereas those further away can be seen much more clearly. Those with more severe forms of long sightedness who experience problems carrying out everyday activities due to poor eyesight may find that the condition can be managed well with either glasses or contact lenses, but these treatments aren't suitable for everyone. The younger generation, avid sports players, and those who cannot wear contact lenses, for example, may wish to explore some of the more permanent treatment options currently available in the UK.

How Do I Know If I Have Hyperopia?

The best way to tell if you have hyperopia is to visit your optician and have an eye test. Long sightedness is very simple to diagnose, and can be done in a number of ways. A basic vision test is one such method. Using a standard, wall-mounted eye chart, your optician should have a reasonably good idea as to whether you have any difficulty making out letters or numbers that appear to be closer, than those appearing further away.

Hyperopia can also be diagnosed through a physical examination of the eye, using a torch. When light shines into the eye, the optician will be able to see the angle of refraction using a retinoscope, and can accurately determine if you're suffering from hyperopia, or from short sightedness, also known as myopia. The exact extent of your visual impairment can be diagnosed through a phoropter.

Long sightedness

Close up objects are often distorted, whereas those further away can be seen much more clearly.

However, even without visiting an optician, you should have some idea as to whether or not you're suffering from long sightedness based upon the presence of some of the classic symptoms of the condition. Of course, the most common and often most noticeable symptom is that you struggle to focus on objects that are near to you, but have little trouble with objects placed further away, but hyperopia sometimes presents with an array of other symptoms. For example, you may start to notice that you're beginning to squint, as if you are constantly looking at a bright light. Squinting is actually a subconscious method of improving eyesight, and research has shown that squinting can improve the quality of the visual image in sufferers presenting with up to +3.00 diopter. However, as +3.00 diopter represents a very mild case of hyperopia, squinting is unlikely to provide a long term or widespread solution. You may also notice that your eyes feel tired, even when your body is still wide awake, or that your eyes are quite painful.

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Treating Hyperopia

Contact lenses and glasses are frequently used to treat cases of hyperopia that affect day to day life. The type of lens used is curved in such a way that light is refracted at a different angle, producing a clearer visual image for the wearer. However, for those who are looking for a more permanent solution, laser eye surgery may be an option.

Hyperopia And Laser Eye Surgery

There are three types of laser eye surgery that are suitable for treating hyperopia:

PRK and LASEK are very similar procedures and involve removing the outer layer of the cornea before the inside of the cornea is reshaped into a more natural position. LASIK, on the other hand, is a more advanced technique. Rather than removing the outer layer of the cornea completely, a flap is created, so the covering can simply be hinged into an open position, in much the same way as you would open a door.

As for which option is best for treating hyperopia, research indicates that both types of method generally produce similar results in long sighted patients, with around 95% of patients experiencing a noticeable improvement in their eyesight following surgery. However, there are some aspects to consider that may make LASIK seem like a more attractive option. Transactions of the American Ophthalmology Society conclude that patients report significantly less postoperative pain following LASIK, and that over-correction leading to mild short sightedness is a greater risk with LASEK and PRK.

If you're considering laser eye surgery to correct hyperopia, it's well worth having a comprehensive consultation with an experienced surgeon to determine which type of surgery would be best for you.

Have I Done Anything To Cause it?

Long sighted patient

Rest assured that hyperopia cannot be caused by something that you do or don't do. The condition comes about because of abnormalities with the shape of the eye, usually a 'short' eyeball, a flat cornea that doesn't curve as a normal cornea would, or a lens that is extremely thick and isn't flexible enough to cooperate fully with the movement of the eye. All of these factors affect light refraction in such a way as to contribute to long sightedness. It's widely believed that these shape-related abnormalities are present from birth and are inherited from our parents, but researchers have so far failed to determine exactly which gene is responsible for the condition, if this is, in fact, the case.

Although it's very likely that hyperopia is present from birth, it's perhaps somewhat odd that the incidence of long sightedness increases with age. There are two potential reasons for this. The first can be put down to inaccurate figures as the older generation are much more likely to attend regular eye examinations than their younger counterparts, despite eye tests being free for under 16's in the UK. Therefore, the number of under 25's with the condition could well be far greater than the estimated 13 percent.

The second reason is that there is a sub division of hyperopia, known as presbyopia. The conditions are exactly the same in terms of symptoms and refraction error, but presbyopia is caused by the natural ageing of the eye. As the eye ages, the lens becomes stiffer, so it causes the same sort of visual impairment as a thick lens in a younger person.

In spite of the widespread belief that hyperopia is a hereditary condition, some studies have suggested that there could be contributing factors other than genetics. For example, the British Journal of Ophthalmology has put forward a notion that high blood glucose levels can cause hyperopia, which is fitting as diabetics tend to suffer from long sightedness much more commonly than short sightedness. The Archives of Ophthalmology also puts forward the idea that certain tumours around the eyes can cause hyperopia: specifically, intraconal tumours that form around the optic nerve.

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